Spiritual Science and MedicineLecture I

Schmidt Number: S-4036

On-line since: 10th March, 2000

WE MAY
take it as obvious that only a very small proportion of what my
present hearers probably expect for the future of their professional
life can be indicated in this series of lectures; for you will all
agree that any confidence in the future among medical workers depends
on the reform of the actual medical curriculum. It is impossible to
give any direct impetus to such reform by means of a course of
lectures. The most that may possibly result is that certain
individuals will feel the urge to help and participate in such reform.
Any medical subject under discussion today has, as its background,
those initial studies in anatomy, physiology and general biology,
which are the preliminaries to medicine proper. These preliminaries
bias the medical mind in a certain direction from the first; and it is
absolutely essential that such bias should be rectified.

In this series of lectures I should like, in the first place, to
submit to you some facts bearing on the obstacles in the customary
curriculum to any really objective recognition of the nature of
disease per se. Secondly, I would suggest the direction in which we
should seek that knowledge of human nature which can afford a real
foundation for medical work. Thirdly, I would indicate the
possibilities of a rational therapy based on the knowledge of the
relationship between man and the surrounding world. In this section I
would include the question whether actual healing were possible and
practicable.

Today I shall restrict myself to introductory remarks, and to a kind
of orientation. My principal aim will be to collect for consideration
from Spiritual Science all that can be of value to physicians. It is
my wish that this attempt should not be confused with an actual
medical course, which it nevertheless will be in a sense. But I shall
give special attention to everything that may be of value to the
medical worker. A true medical science, or art, if I may call it so,
can only be attained by consideration of the factors to which I have
referred.

Probably you have all, in thinking over the task of the physician,
been baffled by the question: “What does sickness mean and what is a
sick human being?” The most usual definition or explanation of
sickness in general and of sick people, is that the morbid process is
a deviation from the normal life process; that certain facts which
affect human beings, and for which normal human functions are not in
the first place adapted, cause certain changes in the normal life
process and in the organisation; and that sickness consists in the
functional deficiency of the organs caused by such changes. But you
must admit that this is a merely negative definition. It offers no
help when we are dealing with actual diseases. It is just this
practical help that I shall aim at here, help in dealing with actual
diseases. In order to make things clear it seems advisable to refer to
certain views, which have developed in the course of time, as to the
nature of disease; not as indispensable for the present interpretation
of morbid symptoms, but as signposts showing the way. For it is easier
to recognise where we are now if we appreciate former points of view
which led up to those now current.

The accepted version of the origin of medicine derives it from the
Greece of the fifth and fourth centuries before the Christian era,
when the influence of Hippocrates was supreme. Thus an impression is
produced that the system of Hippocrates — which developed into the
Humoral pathology accepted until well into the nineteenth century —
was the first attempt at medicine in the Occident. But this is a
fundamental error, and is still harmful as a hindrance to an
unprejudiced view of sickness. We must, to begin with, clear this
error away. For an unbiased view the conceptions of Hippocrates which
even survived until the time of Rokitansky, that is until the last
century — are not a beginning only, but to a very significant degree
are a conclusion and summary of older medical conceptions. In the
ideas which have come down to us from Hippocrates we meet a final
filtered remainder of ancient medical conceptions. These were not
reached by contemporary methods, i.e., through anatomy, but by the
paths of ancient atavistic vision. The most accurate abstract
definition of Hippocratic medicine would be: the conclusion of archaic
medicine based on atavistic clairvoyance. From an external point of
view, we may say that the followers of Hippocrates attributed all
forms of sickness to an incorrect blending of the various humours or
fluids which co-operate in the human organism. They pointed out that
these fluids bore a certain ratio to one another in a normal organism,
and that this ratio was disturbed in the sick human body. They termed
the healthy mixture or balance Krasis, the improper mixture Dyskrasis.
The latter had to be influenced so that the proper blend might be
restored. In the external world, they beheld four substances which
constituted all physical existence: Earth, Water, Air and Fire — Fire
meaning what we describe simply as warmth. They held that these four
elements were specialised in the bodies of man and the animals, as
black bile, yellow bile, (gall) mucus (slime), and blood, and that the
human organism must therefore function by means of the correct
blending of these four fluids.

The contemporary man with some kind of scientific grounding, who
considers this theory, argues as follows: the blending and interaction
of blood, mucus, bile and gall, in due proportion, must produce an
effect according to their inherent qualities known to chemistry. And
this restricted view is thought to be the essence of Humoral
pathology; but erroneously. Only one of the four “humours,” the most
Hippocratic of all — as it appears to us today — namely “black bile”
was believed to work through its actual chemical attributes on the
other “humours.” In the case of the remaining three fluids, it was
believed that besides the chemical properties there were certain
intrinsic qualities of extra-telluric origin. (I am referring to the
human organism for the moment, excluding animals from consideration.)
Just as water, air and fire were believed to be dependent on
extra-telluric forces, so also these ingredients of the organism were
believed to be inter-penetrated with forces emanating from beyond the
earth.

In the course of evolution, western science has completely lost this
reference to extra-terrestrial forces. For the scientist of today,
there is something absolutely grotesque in the suggestion that water
possesses not only the qualities verifiable by chemical tests, but
also, in its action within the human organism, qualities appertaining
to it as a part of the extra-terrestrial universe. Thus the Ancients
held that the fluids of the human body carried into the organism
forces derived from the cosmos itself. Such cosmic forces were
regarded less and less as the centuries went on; but nevertheless
medical thought was built up on the remains of the fading conceptions
of Hippocrates until the fifteenth century. Contemporary scientists
therefore have great difficulty in understanding pre-fifteenth century
treatises on medical subjects; and we must admit that the writers of
these treatises did not, as a rule, themselves fully comprehend what
they wrote. They talked of the four elements of the human organism,
but their special description of these elements was derived from a
body of wisdom that had really perished with Hippocrates.
Nevertheless, the qualities of these fluids were still matters of
discussion and dispute. In fact, from the time of Galen till the
fifteenth century, we find a collection of inherited maxims that
become continuously less and less intelligible. Yet there were always
isolated individuals able to perceive that there was something beyond
what could be physically or chemically verified, or included in the
merely terrestrial. Such individuals were opponents of what “humoral
pathology” had become in current thought and practice. And chief among
them were Paracelsus and Van Helmont, who lived and worked from the
end of the fifteenth century into the seventeenth, and contributed
something new to medical thought, by their attempts to formulate
something their contemporaries no longer troubled to define. But the
formulation they gave could only be fully understood with some
remainder of clairvoyance, which Paracelsus and Van Helmont certainly
possessed. If we ignore these facts, we cannot arrive at any
conclusion concerning peculiarities of medical terminology whose
origin is no longer recognisable.

Paracelsus assumed the existence of the Archaeus, as the foundation
for the activity of the organic “humours” in man; and his followers
accepted it. He assumed the Archaeus, as we today speak of the
“Etheric” body of man.

Whether we use the term Archaeus, as Paracelsus did, or our term, the
etheric body, we refer to an entity which exists but whose origin we
do not trace. If we were to do this, our argument would be as follows:
Man possesses a physical organism
(see
Diagram No. 1)
mainly constructed by forces acting
out of the sphere of the earth; and also an etheric organism
(Diagram No. 1 in Red)
mainly constructed by forces acting from the cosmic
periphery. Our physical body is a portion as it were of the whole
organism of our Earth. Our etheric body — like the Archaeus of
Paracelsus — is a portion of that which does not belong to the earth,
but which acts on and affects the earth from all parts of the cosmos.
Thus Paracelsus viewed what was formerly designated the cosmic element
in man — of which the knowledge had perished with Hippocratic
medicine — in the form of an etheric body, which is the basis of the
physical. But he did not investigate further — though he gave some
hints — the extra-terrestrial forces associated with the Archaeus and
acting in it.

The exact significance of such facts grew more and more obscure,
especially with the advent of Stahl's medical school in the
seventeenth and eighteenth centuries. Stahl's school has wholly ceased
to comprehend this working of cosmic forces into terrestrial
occurrences; it grasps instead at vague concepts such as “vital force”
and “spirits of life.” Paracelsus and Van Helmont were consciously
aware of the reality at work between the soul and spirit of man and
his physical organisation. Stahl and his followers talk as though the
conscious soul-element was at work, though in another form, upon the
structure of man's body. This naturally provoked a vehement reaction.
For if one proceeds like this and founds a sort of hypothetic vitalism
one comes to purely arbitrary assertions, and the nineteenth century
opposed these assertions. Only a very great mind, like Johannes Müller
(the teacher of Ernst Haeckel), who died in 1858, was able to overcome
the noxious effects of this confusion, a confusion of soul forces with
“vital forces” which were supposed to work in the human organism,
although how they operated was not very clear.

Meanwhile a quite new current made its appearance. We have followed up
the other current which faded out; the new current in the nineteenth
century had a rather different bearing upon medical thought. It was
set in motion by one extremely influential piece of work dating from
the preceding century: the De sedibus et causis morborum per anatomen
indugatis by Morgagni. Morgagni was a physician of Padua, who
introduced an essentially materialistic trend into medicine; the term
materialism is used here, of course, as an objective description,
without sympathies and antipathies. The new trend initiated by
Morgagni's work consisted in turning the interest to the after-effect
of disease upon the organism. Post-mortem dissections were regarded as
decisive; they revealed that whatever the disease may have been,
typical effects could be studied in certain organs, and the changes of
the organs by disease were studied from the autopsy. With Morgagni,
pathological anatomy begins, whereas the former content of medicine
still retained some traces of the ancient element of clairvoyance.

It is of interest to observe the suddenness with which this great
change finally occurred. The volte-face took place within two decades.
The ancient inheritance was abandoned and the atomistic-materialistic
conception in modern medicine was founded. Rokitansky's
Pathological Anatomy
(published in 1842) still contains some traces of the
“Humoral” tradition; of the conception that illnesses are due to the
abnormal interaction of the fluids. Rokitansky achieved a brilliant
combination of the study of organic change, with a belief in the
importance of the fluid (humours); but it is impossible to consider
these bodily fluids adequately without some recognition of their
extra-terrestrial qualities. Rokitansky referred the degenerative
changes revealed in autopsies to the effect of the abnormal mixture of
the bodily fluids. Thus the last visible trace of the ancient
tradition of “Humoral pathology” was in the year 1842. The
interlocking of this perishing heritage of the past with attempts such
as Hahnemann's — attempts forecasting future trends of dealing with
more comprehensive concepts of disease — we shall consider in the
next few days, for this subject is far too important to be relegated
to an introduction. Similar experiments must be discussed in their
general connection and then in detail.

The two decades immediately following the appearance of Rokitansky's
book were decisive for the growth of the atomistic-materialistic
conception in medicine. In the first half of the nineteenth century
there were curious echoes of the ancient conceptions. Thus, for
example, Schwann may be termed the discoverer of the vegetable cell;
and he believed that cells were formed out of a formless fluid
substance to which he gave the name Blastem, by a process of
solidification, so that the nucleus emerges together with the
surrounding protoplasm. Schwann derived cells from a fluid with the
special property of differentiation, and believed that the cell was
the result of such differentiation. Later on the view gradually
develops that the human frame is “built up” of cells; this view is
still held today; the cell is the “elementary organism,” and from the
combination of cells, the body of man is built up.

This conception of Schwann's, which can be read “between the lines”
and even quite obviously, is the last remainder of ancient medical
thought, because it is not concerned with atomism. It regards the
atomistic element, the cell, as the product of a fluid which can never
properly be considered as being atomistic — a fluid which contains
forces and only differentiates the atomistic from itself. Thus in
these two decades, the forties and fifties of the nineteenth century,
the older, more universal view approaches its final end, and the
atomistic medical view shows its faint beginnings. And it has fully
arrived when, in 1858, appeared the
Zellular Pathologie
(Cellular Pathology)
of Virchow. Between
Pathologischen Anatomie,
1842, by Rokitansky and
Zellular Pathologie,
1858, by Virchow one must actually
see an immense revolution — proceeding in leaps and bounds — in the
newer medical thinking. Cellular Pathology derives all the
manifestations of the human organism from cellular changes. The
official ideal henceforth consists in tracing every phenomenon to
changes in the cells. From the change in the cell the disease is
supposed to be understood. The appeal of this atomism is its
simplicity. It makes everything so easy, so evident. In spite of all
the progress of modern science, the aim is to make everything quickly
and easily understood, regardless of the fact that nature and the
universe are essentially extremely complex.

For example: It is easy to demonstrate through a microscope that an
Amoeba, in a drop of water, changes form continuously, extending and
retracting its limb-like projections. It is easy to raise the
temperature of the water, and to observe the greater rapidity with
which the pseudo-podia protrude and retract, until the temperature
reaches a certain point. The amoeba contracts and becomes immobile,
unable to meet the change in its environment. Now, an electric current
can be sent through the water, the amoeba swells like a balloon, and
finally bursts if the voltage becomes too high. Thus it is possible to
observe and record the changes of a single cell, under the influence
of its environment; and it is possible to construct a theory of the
origin and causation of disease, through cumulative cellular change.

What is the essential result of this revolution which took place in
two decades? It lives on in everything that permeates the acknowledged
medical science of today. It is the general tendency to interpret the
world atomistically which has gradually arisen in the age of
materialistic thought.

As I stated at the beginning of this address, the medical worker today
must of necessity inquire: What sort of processes are those we term
diseased? What is the essential difference between the diseased and
the so-called normal processes in the human organism? Only a positive
representation of this deviation is practicable, not the official and
generally accepted definitions, which are merely negative. These
deviations from normality are stated to exist, and then there are
attempts to find how they may be removed. But there is no penetrating
conception of the nature of the human being. And from the lack of such
a conception our whole medical science is suffering. For what, indeed,
are morbid processes? It cannot be denied that they are natural
processes, for you cannot make an abstract distinction between any
external natural process, whose stages can be observed, and a morbid
process within the body. The natural process is called normal, the
morbid one abnormal, without showing why the process in the human
organism differs from normality. No practical treatment can be
attained without finding out. Only then can we investigate how to
counter-balance it. Only then can we find out from what angle of
universal existence the removal of such a process is possible.
Moreover, the term “abnormal” is an obstacle to understanding; why
should such-and-such a process in man be termed abnormal? Even a
lesion, such as a wound or deep cut with a knife, in the finger, is
only relatively “abnormal,” for to cut a piece of wood is “normal.”
That we are accustomed to other processes than the cutting of a finger
says nothing; it is only playing with words. For what happens through
the cutting of my finger is, when viewed from a certain angle, as
normal as any other natural process. The task before us is to
investigate the actual difference between the so-called diseased
processes, which are after all quite normal processes of nature, but
must be occasioned by definite causes, and the other processes, which
we call healthy and which occur every day. We must ascertain this
essential difference; it cannot, however, be ascertained without a
knowledge of man which leads to his essential being. I shall give you,
in this introduction, the first elements; we shall later on proceed to
the details.

As these lectures are limited in number, you will understand that I am
principally giving things which you cannot find in books or lectures
and am assuming the knowledge presented in those sources. It would not
seem to me worth while to put a theory before you, which you could
find stated and illustrated elsewhere.

Let us therefore begin here with a simple visual comparison which you
can all make: the difference between a human skeleton and that of a
gorilla, an ape of so-called high grade. Compare the visible outlines
and proportions of these two bony frameworks. The most conspicuous
feature of the gorilla, in point of size, is the development of the
lower jaw and its appurtenances. This enormous jaw seems to weight
down, to overload, the whole bony structure of the head
(see
Diagram 2),
so that the
gorilla appears to stand upright only with an effort. But there is the
same weightiness in comparison with the human skeleton, if you examine
the forearms and hands and fingers. They are heavy and clumsy in the
gorilla; whereas in man they are delicate and frail; there the mass is
less obvious. Just in these parts, the system of the lower jaws and
forearms with the fingers, the mass recedes in man, whereas it is very
obvious in the gorilla. The same comparative peculiarities of
structure can be traced in the lower limbs and feet of the two
skeletons. There, too, we find a certain weight pressing in a definite
direction. I should like to denote the force which one can see in the
systems of underjaw, arm, leg, foot — by means of this
[e.Ed: down and left slanting arrow.]
line in the diagram.
(See
Diagram 3).

These differences in structure suggest to the observer that in human
beings, where the weight of the jaws recede and the arms and finger
bones are delicate, the downward pressing forces are countered
everywhere by a force directed upwards and away from the earth. The
formative forces in man must be represented in a certain parallelogram
of forces which results from the same force which is directed upwards
and which the gorilla appropriates externally only, standing upright
with difficulty. I then arrive at a parallelogram of forces that is
formed by this line and by this one.
(See
Diagram 4).

As a rule nowadays we are content to compare the bones and muscles of
the higher animals with our own, but to ignore the changes in form and
posture. Yet the contemplation of the formative changes is of
essential significance. There must be certain forces acting against
those other forces which mould the typical gorilla frame. They must
exist. They must operate. In seeking them we shall find that which has
been lost inasmuch as the ancient medical wisdom has been filtered
from the system of Hippocrates. The first set of forces in the
parallelogram are of a terrestrial nature, while the other set of
forces which unite with the terrestrial forces so as to form a
resultant which is not of terrestrial origin, must be sought outside
the terrestrial sphere. We must search for tractive forces which bring
man into the upright posture, not merely on occasion, as among the
higher mammals, but so that these forces are at the same time
formative. The difference is obvious: the ape if he walks upright has
to counteract forces which oppose the erection with their mass;
whereas man forms his very skeleton in accordance with forces of a
non-terrestrial nature. If one not only compares the particular bones
of the man with those of the animal, but examines the dynamic
principle in the human skeleton, one finds that there is something
unique and not to be found in the other kingdoms of nature. Forces
emerge that we have to combine with the others to make the
parallelogram. We find resultants not to be found among the forces of
extra-human nature. Our task will be to follow up systematically this
“jump” leading from animal to man. Then we can find the origin and
essence of “sickness” in animals as well as in man. I can only
indicate little by little these lines of inquiry; we shall find much
of importance from these elements as we continue further.

Now let me mention another fact, which concerns the muscular system.
There is a remarkable difference in muscular reactions; when in
repose, the chemical reactions of the muscles are alkaline, though
very slightly so in comparison with most other alkaline reactions.
When in action, the muscular reactions are acid, though also faint.
Now consider that from the point of view of metabolism the muscle is
formed out of assimilated material, that is, it is a result of the
forces present in terrestrial substances. But when man passes to
action the normal properties of the muscle, as a substance affected by
ordinary metabolism, are overcome. This is quite evident. Changes take
place in the muscle itself, which are different from ordinary
metabolic processes, and can only be compared with the forces active
in the human bone-system. Just as these formative forces in man
transcend what he has from outside, inter-penetrating terrestrial forces
and uniting with them so that a resultant arises, so we must recognise
the force that is manifested through the altered metabolism of muscles
in action, as something working chemically from outside the earth into
terrestrial chemistry. Here we have something of an extra-terrestrial
nature, which works into earthly mechanics and dynamics. In metabolism
there is something active beyond terrestrial chemistry, and capable of
other results than those caused by terrestrial chemistry alone.

Those considerations, which are concerned both with forms and
qualities, must be the starting point in our quest for what really
lies in the nature of man. Thus we may also find the way back to what
we have lost, yet sorely need if we are not to stop at formal
definitions of disease that cannot be of much use in actual practice.
An important question arises here. Our materia medica contains only
terrestrial substances taken from man's environment, for the
treatment of the human organism which has suffered changes. But there
are non-terrestrial processes active in him — or at least forces
which cause his processes to become non-terrestrial — and so the
question arises: how can we provoke an interaction leading from
sickness to health, by methods affecting the sick organism through its
physical earthly environment? How can we initiate an interaction which
shall include those other forces, which work in the human organism,
yet are not limited to the scope of the processes from which we take
our remedies, even when they take effect through certain forms of
diet, etc.?

You will realise the close connection between a correct conception of
human nature and the methods that may lead to a certain therapy. I
have intentionally chosen these first elements which are to lead us to
an answer, from the differences between animals and men, although well
aware of the objection that animals, like men, are subject to
diseases, that even plants may become diseased, and that morbid states
have recently been spoken of even among minerals; and that there
should therefore be no distinction between sickness in animals and in
the human race. The difference will become obvious when it will be
apparent how little value in the long run, adheres to the results of
animal experimentation undertaken solely to gain knowledge for use in
human medicine. We shall consider why it is undoubtedly possible to
attain some help for mankind through experiments on animals, but only
if and when we understand the radical differences, even to the
smallest detail, between animal and human organisms.

I want to emphasise that in referring to cosmic forces, far greater
demands are made on man's personality than if we merely refer to
so-called objective rules and laws of nature. The aim must be set
before us to make medical diagnosis more and more a practice of
intuition; the gift of basing conclusions on the formative phenomena
of the individual human organism (which may be healthy or sick) can
show how this training in intuitive observation of form will play an
ever-increasing part in the future development of medicine.

These suggestions are only intended to serve as a sort of introductory
orientation. Our concern today was to show that medicine must once
more turn its attention to realms not accessible through chemistry or
Comparative Anatomy as usually understood, realms only to be reached
by consideration of the facts in the light of Spiritual Science. There
are still many errors on this subject. Some hold the main essential
for the spiritualising of medicine to be the substitution of spiritual
means for material. This is quite justifiable in certain departments,
but absolutely wrong in general. For there is a spiritual method of
knowing the therapeutic properties of material remedies; spiritual
science can be applied to evaluate material remedies. This will be the
theme of that portion of our subject matter which I have termed the
possibilities of healing through recognition of the
inter-relationships between mankind and the external world.

I shall hope to base what I have to say about special methods of
healing on as firm a foundation as possible, and to indicate that in
every individual case of sickness it is possible to form a picture of
the connection between the so-called “abnormal” process, which must
also be a process of nature, and those “normal” processes which again
are nothing else than nature processes. This primary problem of how
the disease process can be regarded as a natural process has often
cropped up. But the issue has been evaded again and again. I find
certain facts about Troxler of great interest in this connection.
Troxler taught medicine at the University of Berne and in the first
half of the last century he devoted much energy to maintaining that
the “normality of disease” should be investigated; that such
investigation would finally lead to the recognition of a certain world
connected with our own, and impinging on our world, as it were,
through illegitimate gaps; and that this would be the key to something
bearing on morbid phenomena. Please imagine such a diagrammatic
picture; a world in the background whose laws, in themselves
justified, could cause morbid phenomena amongst the human race. Then,
if this world meets and interpenetrates our own, through certain
“gaps,” its laws, which are adapted to another world, could do
mischief here. Troxler wanted to work in this direction. And however
obscure and difficult his expressions on many subjects may be, one
notes that he had struck out a path for himself in medicine, with the
purpose of working towards a certain restoration of medical science.

A friend and I once had the opportunity of inquiry into Troxler's
standing amongst his Bernese colleagues and into the results of his
initiative. The detailed
History of the University
had only one thing
to say about Troxler: that he had caused much disturbance in the
university! That had been remembered and recorded, but we could find
nothing about his significance for science.